Combined photodynamic therapy and intravitreal triamcinolone for neovascular age-related macular degeneration: effect of initial visual acuity on treatment response.

Combined photodynamic therapy and intravitreal triamcinolone for neovascular age-related macular degeneration: effect of initial visual acuity on treatment response. Research Abstract Details 

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Combined photodynamic therapy and intravitreal triamcinolone for neovascular age-related macular degeneration: effect of initial visual acuity on treatment response. Abstract Text:

Ramin Schadlu,Steven M Kymes,Rajendra S Apte,Ramin Schadlu,Steven M Kymes,Rajendra S Apte,

PURPOSE: To evaluate visual outcomes in combination therapy with photodynamic therapy (PDT) and intravitreal triamcinolone acetonide (IVTA) for subfoveal choroidal neovascularization (CNV) from age-related macular degeneration (AMD). METHODS: Charts of 39 eyes from 38 patients with exudative AMD treated with PDT and 4 mg of triamcinolone acetate injected intravitreally were reviewed retrospectively. Visual data, angiographic lesion type, prior PDT exposure, number of treatments, and follow-up were recorded. Snellen visual acuities were converted to LogMAR for all calculations. Lines of vision lost or gained pertain to calculated ETDRS lines of vision (via LogMAR). RESULTS: Twenty-two of the choroidal neovascular membranes were occult, and 17 were classified as predominantly classic. Mean follow-up was 43 weeks. The average number of treatments was 2.23. At final follow-up, 11 eyes (28.21%) experienced improved visual acuity, 8 eyes (20.51%) were stable, and 20 eyes (51.28%) had worsened. No significant difference in treatment response was found between angiographic subtypes (p > 0.59). Lack of previous PDT exposure did not improve treatment outcomes (p > 0.77). Pre-treatment visual acuity (PTVA) was determined as a strong predictor of treatment outcome in our study cohort. Visual acuity of 20/200 or worse was associated with a 40.9% chance of some improvement and a 35.75% chance of three or more lines of improvement. Visual acuity better than 20/200 was associated with an 89.4% chance of no improvement and a 58.8% chance of three or more lines of visual loss. CONCLUSION: Counter to previously reported results with combination therapy, the majority of our patients (72%) did not demonstrate improved vision and 51% lost vision. When PTVA was accounted for, selected patients benefitted significantly from treatment. PTVA may be a useful and simple patient selection tool for combination treatment with PDT and IVTA.

Combined photodynamic therapy and intravitreal triamcinolone for neovascular age-related macular degeneration: effect of initial visual acuity on treatment response. Publishing Authors By Initials

R Schadlu,SM Kymes,RS Apte,R Schadlu,SM Kymes,RS Apte,

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Combined photodynamic therapy and intravitreal triamcinolone for neovascular age-related macular degeneration: effect of initial visual acuity on treatment response. Journal Published:

PUBLICATION TYPE: Journal Article

Journal: Graefe's archive for clinical and experimental oph

VOLUME: 245

Page Numbers: 1667-72

Journal Abbreviation: Graefes Arch. Clin. Exp. Ophth

ISSN: 0721-832X

DAY: 22

MONTH: 06

YEAR: 2007

Combined photodynamic therapy and intravitreal triamcinolone for neovascular age-related macular degeneration: effect of initial visual acuity on treatment response. Information

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LANGUAGE: eng

NlmUniqueID: 8205248

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AFFILIATION: Department of Ophthalmology and Visual Sciences, Washington University in St. Louis School of Medicine, Barnes Retina Institute, St. Louis, MO 63110, USA.

Country: Germany

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MEDLINETA: Graefes Arch Clin Exp Ophthalm

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